Rativol Special Precautions

Ketorolac Trometamol can cause gastrointestinal irritation, ulcers, perforation or bleeding with or without previous symptoms and should be given under close supervision to patients with a history of gastrointestinal tract disease.
The use of drugs which inhibits prostaglandin synthesis might be expected to further decrease renal blood flow. Caution is advised if Ketorolac Trometamol is used in such circumstances. Close monitoring of urine output, serum urea and serum creatinine is recommended until the patient is normovolaemic.
Inhibits platelet aggregation and may prolong bleeding time. It does not change the thromboses amount, Prothrombin Time (PT), and Partial Thromboplastin Time (PTT).
Borderline elevations of one or more liver tests may occur. These abnormalities may progress, may remain unchanged or may be transient with discontinued therapy. Patients with impaired hepatic function from cirrhosis do not have any clinically important changes in Ketorolac clearance. Ketorolac Trometamol is not recommended for use as a pre-operative medication, for support of anesthesia or in obstetrical analgesia.
It is not recommended that Ketorolac Trometamol used with other non-steroidal anti-inflammatory drugs, because of potential for additive side effects.
Renal function should be monitored in patients who have had more than a single i.m. dosage of Ketorolac, particularly in elderly patients.
Fluid retention and oedema have been reported with the use of Ketorolac Trometamol therefore, it should be used with caution in patients with cardiac decompensation, hypertension or similar conditions.
Ketorolac Trometamol is not recommended during pregnancy, labour, or delivery.
Ketorolac Trometamol is not recommended for treatment of nursing mother. Secretion of Ketorolac in human milk after ingestion of Ketorolac is limited.
Ketorolac Trometamol is not recommended for use in children under 16 years of age because of safety and efficacies in children have not been established.
Patients over 65 years may be at greater risk than younger patients for adverse events. This age related risk is common to drugs that inhibit prostaglandin synthesis. The lowest effective dose should be used in elderly patients.